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APPLICATION- SITE APPROVAL <br /> PRIVATE RIGHT OF WAY- ANTIQUATED SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> [ SITEIMPROVEMENTS AND SERVICE'S <br /> Water <br /> Public Water Service Provider Annex-Formation Distance to Public wafer <br /> Proposed% Required Woof) <br /> Existing❑ <br /> Private Water WL Existing Well ❑ New Well II Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Service Provider Annex-Formation Distance to Public Sewer <br /> Disposal Required Facility <br /> Proposed❑ <br /> Existing❑ <br /> On-site Sewage Existing Septic System ❑ New Septic System A;-- Other ❑/ <br /> Disposal, <br /> Storm Drainage <br /> Public Storm Service Provider(it Public) Annex-Formation Terminal Drainage Detention-Refention <br /> Drainage Required fo: Ponds <br /> Proposed❑ <br /> Existing❑ <br /> Pnvate Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change Other ❑ <br /> Drainage X <br /> Electricity Telephone'Service <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> /Sa' �cac <br /> School Service File Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> School Station <br /> Cr/ JI,�a UN�`rly sc`lolrc— Sltif�r�S I13c '7Y ��'� �iSji<��t r7la- <br /> ExistintJ Roads <br /> Road/Street Name R.O.W Width Pavement hfdth Curb/Gutter Sidewalks <br /> T(14L y 9v z3 r 1q) Yes❑ No 0 Yes❑ Noo <br /> C,/004.'s <br /> r Yes❑ No Pg' Yes❑ No PJ <br />